Aggressive Dog Complaint Form

Dog Park Complaint Submit Form:(use to report issues that happen at either of our Dog Parks)

PLEASE TELL US ABOUT YOURSELF (submitter's information):

Name: Address: City: State: Phone: Email:

Ok to Contact me: Yes No

PLEASE TELL US ABOUT THE INCIDENT:On this Date: Day of the Week: Time:

Which Dog Park was this at: Simi Dog Park or Oak Canyon Dog Park

Location: Big Dog Side = Small Dog Side =

THE FOLLOWING INCIDENT OCCURRED:

PLEASE DESCRIBE THE DOG THAT CREATED THE PROBLEM:Dog Name if known: Breed/Type if known: Color(s) of Dog: Sex: Age: Size: Dog Tag/License if known: Weight: Distinguishing Characteristics: Miscellaneous Information:

PLEASE TELL US ABOUT THE PERSON WITH THE DOG (if known):Name of the person with Dog: Was the person with the Dog the owner?: Their phone #: Their Car license plate #: Car License State: Car Make: Car Model: Car Color(s):